Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising ...Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising minimally invasive therapeutic option,aiming to provide targeted treatment with improved patients’outcomes.This review aims to shed light on current evidence about the efficacy,safety,and clinical outcomes of EUS-RFA in the management of pancreatic neoplasms.We conducted a comprehensive search of literature,reviewing studies that document the application of EUS-RFA in pancreatic masses.The key metrics for efficacy included tumor size reduction,pain relief,and overall survival,while safety outcomes focused on procedural complications and post-operative recovery.EUS-RFA has demonstrated potential in effectively managing both benign and malignant pancreatic neoplasms,with several studies reporting significant reductions in tumor size and symptomatic relief.The technique is associated with a favorable safety profile,characterized by a low incidence of major complications.EUS-RFA represents a valuable addition to the therapeutic arsenal for pancreatic neoplasms,offering a viable alternative to surgical interventions,especially in patients with contraindications for surgery.Further studies are needed to establish standardized protocols and long-term outcomes,enhancing its applicability and success in clinical practice.展开更多
AIM To investigate the effect of clonidine on the cutaneous silent period(CSP)during spinal anesthesia.METHODS A total of 67 adult patients were included in this randomized,prospective,single-center,double-blind trial...AIM To investigate the effect of clonidine on the cutaneous silent period(CSP)during spinal anesthesia.METHODS A total of 67 adult patients were included in this randomized,prospective,single-center,double-blind trial.They did not have neurological disorders and were scheduled for inguinal hernia repair surgery.This trial was registered on ClinicalTrials.gov(NTC03121261).The patients were randomized into two groups with regards to the intrathecally administered solution:(1)15 mg of 0.5%levobupivacaine with 50μg of 0.015%clonidine,or(2)15 mg of 0.5%levobupivacaine alone.There were 34 patients in the levobupivacaine-clonidine(LC)group and 33 patients in the levobupivacaine(L)group.CSP and its latency were measured four times:prior to the subarachnoid block(SAB),after motor block regression to the 0 level of the Bromage scale,with ongoing sensory blockade,and both 6 and 24 h after SAB.RESULTS Only data from 30 patients in each group were analyzed.There were no significant differences between the groups investigated preoperatively and after 24 h.The CSP of the L group at the time point when the Bromage scale was 0 was 44.8±8.1 ms,while in the LC group it measured 40.2±3.8 ms(P=0.007).The latency in the L group at the time point when the Bromage scale was 0 was 130.3±10.2 ms,and in the LC group it was 144.7±8.3 ms(P<0.001).The CSP of the L group after 6 h was 59.6±9.8 ms,while in the LC group it was 44.5±5.0 ms(P<0.001).The latency in the L group after 6 h was 110.4±10.6 ms,while in LC group it was 132.3±9.7 ms(P<0.001).CONCLUSION Intrathecal addition of clonidine to levobupivacaine for SAB in comparison with levobupivacaine alone resultsin a diminished inhibitory tonus and shortened CSP.展开更多
Background: ERAS protocols are perioperative interventions aimed at reducing postoperative complications, length of hospital stay (LOS) and early return to normal activities. This has improved outcome in many surgical...Background: ERAS protocols are perioperative interventions aimed at reducing postoperative complications, length of hospital stay (LOS) and early return to normal activities. This has improved outcome in many surgical specialties, including breast surgery. We present the surgical outcome of breast cancer (BC) patients treated over a 12-month period following the principle of ERAS protocols and highlight the underpinning evidence. Methods: A retrospective analysis of all BC patients diagnosed and had breast cancer surgery over 12 months. Data collected included patient’s demographics, type of surgery, LOS, other perioperative care and significant postoperative complications. Excluded were patients with bilateral cancer surgeries, diagnostic excision, margin clearance or breast reconstruction. Results: There were 621 BC diagnosed including 5 male and 12 bilateral female BC. The ages ranged from 25 to 93 years. Excluding bilateral BC, 351 patients (70.2 %) had breast conserving surgery (BCS) while 149 (29.8%) patients had mastectomy as index cancer surgery. Sixteen (4.5%) of the women who initially underwent BCS subsequently had a completion mastectomy. The overall rate of successful BCS was 335/500 (67%). 441 (85.5%) of patients were discharged same or next day. 12 (7.2%) cases of postoperative haematoma, 6 cases of wound infection and a case of seroma requiring surgical/radiological drainage recorded. Conclusion: ERAS protocol in BC surgery is associated with decreased LOS and low complication rate. Delayed discharges are mostly due to adverse social factors and medical comorbidity rather than post-operative surgical complications.展开更多
We describe a modified aural meatoplasty technique. The technique has been mainly used for mastoid surgery but it may also be used to address other causes of meatal stenosis. It involves removing most of the cartilage...We describe a modified aural meatoplasty technique. The technique has been mainly used for mastoid surgery but it may also be used to address other causes of meatal stenosis. It involves removing most of the cartilage in the conchal bowl and soft tissue in the external auditory meatus. Cartilage from the helical root may also be sacrificed as part of this procedure. Our technique produces an excellent cosmetic result and an adequate meatoplasty which is easy to monitor in the outpatient setting.展开更多
Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been appro...Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been approved for this use since 2006 by the National Institute for Health and Clinical Excellence in the UK. The aim of this systematic review is to evaluate the efficacy and safety of this procedure based on the up to date available evidence. Methods: A comprehensive literature search of the Cochrane library, Medline, Embase, PubMed, Google scholar, Trip-database, Internet, and the reference lists of relevant articles was performed. We searched for literature with sizeable cases of therapeutic vacuum-assisted excision of fibroadenomas. All prospective studies with more than 20 study participants were screened. The study quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation [GRADE] approach. All were in English. Results: Of the four case series that fulfilled the inclusion criteria there were 516 patients in which 520 procedures were performed. Overall complete excision rate was 89.4%. In two of the studies, this was 100% when the lesions were less than 1.5 cm but reduced to 61% when between 1.5 and 2 cm. Most common significant complication was bleeding with 2 cases of pneumothorax. None of the studies can be regarded as high quality going by GRADE approach. Conclusion: Within the limit of the current published case series, UGVAE appears to be an effective and safe procedure for excision of small fibroadenomas of less than 15 mm in size. A well designed case control study or randomized controlled trials with a sufficient sample size is needed to further assess its safety, effectiveness and more importantly, patients’ satisfaction especially in larger sized fibroadenomas.展开更多
Two styryl-pyrones, (+)-goniotriol (1) and (+)-8-acetylgoniotriol (2), which are cytotoxic to human turnout cells, were isolated from the ethanolic extracts of the stem bark of Goniothalamus giganteus Hook. F., Thomas...Two styryl-pyrones, (+)-goniotriol (1) and (+)-8-acetylgoniotriol (2), which are cytotoxic to human turnout cells, were isolated from the ethanolic extracts of the stem bark of Goniothalamus giganteus Hook. F., Thomas (Annonaceae), in addition (+)-goniotriol was also isolated from the leaves and twigs of Goniothalamus展开更多
Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, s...Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as components of metabolic syndrome as comorbid conditions, are being incorporated as independent risk factors. We aimed to identify which individual, clinical and hospital characteristics are related to hospital mortality. Objectives: Demonstrate that the Cox proportional hazard model is not appropriate for the analysis of hospital mortality data when diagnostic-related groups are incorporated in the covariate structure. Methods: A retrospective single-center observational study design was used. Sampling was conducted between January 2016 and December 2018. Patients over 10 years, admitted to the emergency department with a precited stay of at least 1 hour were included. Multivariate Cox regression for survival data analyses was employed to analyze the data. Results: The sample consisted of 5897 patients. The mean age of all patients was 32.21 ± 0.29 years old, and the mean length of stay (LOS) was 9.47 ± 0.16 hours. We also categorized patients according to five Diagnosis Related Groups (DGR). Among the patients,1308 suffered from acute leukemia, 1127 had endocrine diseases, 1173 with kidney diseases, and 1016 had respiratory problems. At least one component of metabolic syndrome was present in 27.5% of the patients. During the observation period, 2299 (39%) died in hospital, and 3598 (61%) were discharged alive. We used the multivariate Cox regression non-proportional hazard model to evaluate the joint effect of these factors on the “Length of Stay” or LOS (the dependent variable of Cox regression). Age at admission, the presence of metabolic syndrome, and the DRG were significantly associated with the LOS.展开更多
The rising number of patients with acute limb ischemia (ALI) brings the question if there is an opportunity to make a diagnosis safely and accurately. The current “gold standard” for diagnosis is digital subtraction...The rising number of patients with acute limb ischemia (ALI) brings the question if there is an opportunity to make a diagnosis safely and accurately. The current “gold standard” for diagnosis is digital subtraction angiography (DSA). However, current times show that computed tomography angiogram (CTA) builds popularity among doctors working in vascular surgery departments. The aim of this study is to collect evidence of the use of CTA for the assessment of patients with ALI and compare it to the “gold standard” (DSA). Methodology: This is a narrative synthesis, the search of 4 databases is done for relevant articles within a period from 2000 to 2021. Information extracted will be compared to leading guidelines for ALI published in 2 recent reviews by the American College of Radiology and the European Society for Vascular Surgery. Results: In total 48 articles were obtained: reviews (n = 13), studies (n = 4) and case reports (n = 31). Case reports were excluded from the study. CTA has multiple benefits, which can be put into 4 different groups: availability and accessibility, accuracy, affordability and additional information. Further disadvantages and similarities were discussed in 2 separate groups. Conclusion: The use of CTA in patients with ALI has a notable advantage in all 4 categories (availability, accuracy, affordability, and additional information). Disadvantages and similarities between CTA and DSA, do not vary and do not significantly affect the end decision. This makes CTA a valid tool as the first step in the assessment of the patient with ALI.展开更多
Compounds containing nitrogen stored in bark play a significant role in the growth of trees, especially of deciduous trees. Many physiological and biochemical studies have been made in regard to the composition accumu...Compounds containing nitrogen stored in bark play a significant role in the growth of trees, especially of deciduous trees. Many physiological and biochemical studies have been made in regard to the composition accumulation and mobilization of the nitrogen compounds in bark, but report on the cytological aspect has scarcely been seen. This brief report deals with the protein-storing cells we found in the secondary phloem of Hevea brasiliensis stem.展开更多
Cardiogenic shock(CS)is a complex clinical syndrome with a high mortality rate.It can occur to due to multiple etiologies of cardiovascular disease and is phenotypically heterogeneous.Acute myocardial infarction-relat...Cardiogenic shock(CS)is a complex clinical syndrome with a high mortality rate.It can occur to due to multiple etiologies of cardiovascular disease and is phenotypically heterogeneous.Acute myocardial infarction-related CS(AMI-CS)has historically been the most prevalent cause,and thus,research and guidance have focused primarily on this.Recent data suggest that the burden of non-ischemic CS is increasing in the population of patents requiring intensive care admission.There is,however,a paucity of data and guidelines to inform the management of these patients who fall into two broad groups:those with existing heart failure and CS and those with no known history of heart failure who present with"de novo"CS.The use of temporary mechanical circulatory support(MCS)has expanded across all etiologies,despite its high cost,resource intensity,complication rates,and lack of high-quality outcome data.Herein,we discuss the currently available evidence on the role of MCS in the management of patients with de novo CS to include fulminant myocarditis,right ventricular(RV)failure,Takotsubo syndrome,post-partum cardiomyopathy,and CS due to valve lesions and other cardiomyopathies.展开更多
The authors regret having a mistake in the article title‘Incidental bilateral ovarian paraganglioma of uterine fibroid with widespread adenomyosis:A case report’and change it to‘Incidental bilateral ovarian paragan...The authors regret having a mistake in the article title‘Incidental bilateral ovarian paraganglioma of uterine fibroid with widespread adenomyosis:A case report’and change it to‘Incidental bilateral ovarian paraganglioma in the background of uterine fibroid and widespread adenomyosis:A case report’.The authors would like to apologise for any inconvenience caused.展开更多
Dear editor,Ovarian paragangliomas are rare tumours and are usually incidental.Most of the cases are associated with dermoid cyst of ovary.However,functional paragangliomas1 and paragangliomas leading to peritoneal ca...Dear editor,Ovarian paragangliomas are rare tumours and are usually incidental.Most of the cases are associated with dermoid cyst of ovary.However,functional paragangliomas1 and paragangliomas leading to peritoneal carcinomatosis are also known in literature.2 Due to the varied behaviour of these tumours,correlation with biochemical markers and long term follow up are advised.In this study,we present a lady in her 60's with recent onset of postmenopausal bleeding.She completed her cervical smears till date and had two children by vaginal delivery.Her past medical history includes hypertension and is on Candesartan for the same.She also has type 2 diabetes and is diet controlled.She is a non-smoker and consumes alcohol very occasionally.展开更多
文摘Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising minimally invasive therapeutic option,aiming to provide targeted treatment with improved patients’outcomes.This review aims to shed light on current evidence about the efficacy,safety,and clinical outcomes of EUS-RFA in the management of pancreatic neoplasms.We conducted a comprehensive search of literature,reviewing studies that document the application of EUS-RFA in pancreatic masses.The key metrics for efficacy included tumor size reduction,pain relief,and overall survival,while safety outcomes focused on procedural complications and post-operative recovery.EUS-RFA has demonstrated potential in effectively managing both benign and malignant pancreatic neoplasms,with several studies reporting significant reductions in tumor size and symptomatic relief.The technique is associated with a favorable safety profile,characterized by a low incidence of major complications.EUS-RFA represents a valuable addition to the therapeutic arsenal for pancreatic neoplasms,offering a viable alternative to surgical interventions,especially in patients with contraindications for surgery.Further studies are needed to establish standardized protocols and long-term outcomes,enhancing its applicability and success in clinical practice.
文摘AIM To investigate the effect of clonidine on the cutaneous silent period(CSP)during spinal anesthesia.METHODS A total of 67 adult patients were included in this randomized,prospective,single-center,double-blind trial.They did not have neurological disorders and were scheduled for inguinal hernia repair surgery.This trial was registered on ClinicalTrials.gov(NTC03121261).The patients were randomized into two groups with regards to the intrathecally administered solution:(1)15 mg of 0.5%levobupivacaine with 50μg of 0.015%clonidine,or(2)15 mg of 0.5%levobupivacaine alone.There were 34 patients in the levobupivacaine-clonidine(LC)group and 33 patients in the levobupivacaine(L)group.CSP and its latency were measured four times:prior to the subarachnoid block(SAB),after motor block regression to the 0 level of the Bromage scale,with ongoing sensory blockade,and both 6 and 24 h after SAB.RESULTS Only data from 30 patients in each group were analyzed.There were no significant differences between the groups investigated preoperatively and after 24 h.The CSP of the L group at the time point when the Bromage scale was 0 was 44.8±8.1 ms,while in the LC group it measured 40.2±3.8 ms(P=0.007).The latency in the L group at the time point when the Bromage scale was 0 was 130.3±10.2 ms,and in the LC group it was 144.7±8.3 ms(P<0.001).The CSP of the L group after 6 h was 59.6±9.8 ms,while in the LC group it was 44.5±5.0 ms(P<0.001).The latency in the L group after 6 h was 110.4±10.6 ms,while in LC group it was 132.3±9.7 ms(P<0.001).CONCLUSION Intrathecal addition of clonidine to levobupivacaine for SAB in comparison with levobupivacaine alone resultsin a diminished inhibitory tonus and shortened CSP.
文摘Background: ERAS protocols are perioperative interventions aimed at reducing postoperative complications, length of hospital stay (LOS) and early return to normal activities. This has improved outcome in many surgical specialties, including breast surgery. We present the surgical outcome of breast cancer (BC) patients treated over a 12-month period following the principle of ERAS protocols and highlight the underpinning evidence. Methods: A retrospective analysis of all BC patients diagnosed and had breast cancer surgery over 12 months. Data collected included patient’s demographics, type of surgery, LOS, other perioperative care and significant postoperative complications. Excluded were patients with bilateral cancer surgeries, diagnostic excision, margin clearance or breast reconstruction. Results: There were 621 BC diagnosed including 5 male and 12 bilateral female BC. The ages ranged from 25 to 93 years. Excluding bilateral BC, 351 patients (70.2 %) had breast conserving surgery (BCS) while 149 (29.8%) patients had mastectomy as index cancer surgery. Sixteen (4.5%) of the women who initially underwent BCS subsequently had a completion mastectomy. The overall rate of successful BCS was 335/500 (67%). 441 (85.5%) of patients were discharged same or next day. 12 (7.2%) cases of postoperative haematoma, 6 cases of wound infection and a case of seroma requiring surgical/radiological drainage recorded. Conclusion: ERAS protocol in BC surgery is associated with decreased LOS and low complication rate. Delayed discharges are mostly due to adverse social factors and medical comorbidity rather than post-operative surgical complications.
文摘We describe a modified aural meatoplasty technique. The technique has been mainly used for mastoid surgery but it may also be used to address other causes of meatal stenosis. It involves removing most of the cartilage in the conchal bowl and soft tissue in the external auditory meatus. Cartilage from the helical root may also be sacrificed as part of this procedure. Our technique produces an excellent cosmetic result and an adequate meatoplasty which is easy to monitor in the outpatient setting.
文摘Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been approved for this use since 2006 by the National Institute for Health and Clinical Excellence in the UK. The aim of this systematic review is to evaluate the efficacy and safety of this procedure based on the up to date available evidence. Methods: A comprehensive literature search of the Cochrane library, Medline, Embase, PubMed, Google scholar, Trip-database, Internet, and the reference lists of relevant articles was performed. We searched for literature with sizeable cases of therapeutic vacuum-assisted excision of fibroadenomas. All prospective studies with more than 20 study participants were screened. The study quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation [GRADE] approach. All were in English. Results: Of the four case series that fulfilled the inclusion criteria there were 516 patients in which 520 procedures were performed. Overall complete excision rate was 89.4%. In two of the studies, this was 100% when the lesions were less than 1.5 cm but reduced to 61% when between 1.5 and 2 cm. Most common significant complication was bleeding with 2 cases of pneumothorax. None of the studies can be regarded as high quality going by GRADE approach. Conclusion: Within the limit of the current published case series, UGVAE appears to be an effective and safe procedure for excision of small fibroadenomas of less than 15 mm in size. A well designed case control study or randomized controlled trials with a sufficient sample size is needed to further assess its safety, effectiveness and more importantly, patients’ satisfaction especially in larger sized fibroadenomas.
文摘Two styryl-pyrones, (+)-goniotriol (1) and (+)-8-acetylgoniotriol (2), which are cytotoxic to human turnout cells, were isolated from the ethanolic extracts of the stem bark of Goniothalamus giganteus Hook. F., Thomas (Annonaceae), in addition (+)-goniotriol was also isolated from the leaves and twigs of Goniothalamus
文摘Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as components of metabolic syndrome as comorbid conditions, are being incorporated as independent risk factors. We aimed to identify which individual, clinical and hospital characteristics are related to hospital mortality. Objectives: Demonstrate that the Cox proportional hazard model is not appropriate for the analysis of hospital mortality data when diagnostic-related groups are incorporated in the covariate structure. Methods: A retrospective single-center observational study design was used. Sampling was conducted between January 2016 and December 2018. Patients over 10 years, admitted to the emergency department with a precited stay of at least 1 hour were included. Multivariate Cox regression for survival data analyses was employed to analyze the data. Results: The sample consisted of 5897 patients. The mean age of all patients was 32.21 ± 0.29 years old, and the mean length of stay (LOS) was 9.47 ± 0.16 hours. We also categorized patients according to five Diagnosis Related Groups (DGR). Among the patients,1308 suffered from acute leukemia, 1127 had endocrine diseases, 1173 with kidney diseases, and 1016 had respiratory problems. At least one component of metabolic syndrome was present in 27.5% of the patients. During the observation period, 2299 (39%) died in hospital, and 3598 (61%) were discharged alive. We used the multivariate Cox regression non-proportional hazard model to evaluate the joint effect of these factors on the “Length of Stay” or LOS (the dependent variable of Cox regression). Age at admission, the presence of metabolic syndrome, and the DRG were significantly associated with the LOS.
文摘The rising number of patients with acute limb ischemia (ALI) brings the question if there is an opportunity to make a diagnosis safely and accurately. The current “gold standard” for diagnosis is digital subtraction angiography (DSA). However, current times show that computed tomography angiogram (CTA) builds popularity among doctors working in vascular surgery departments. The aim of this study is to collect evidence of the use of CTA for the assessment of patients with ALI and compare it to the “gold standard” (DSA). Methodology: This is a narrative synthesis, the search of 4 databases is done for relevant articles within a period from 2000 to 2021. Information extracted will be compared to leading guidelines for ALI published in 2 recent reviews by the American College of Radiology and the European Society for Vascular Surgery. Results: In total 48 articles were obtained: reviews (n = 13), studies (n = 4) and case reports (n = 31). Case reports were excluded from the study. CTA has multiple benefits, which can be put into 4 different groups: availability and accessibility, accuracy, affordability and additional information. Further disadvantages and similarities were discussed in 2 separate groups. Conclusion: The use of CTA in patients with ALI has a notable advantage in all 4 categories (availability, accuracy, affordability, and additional information). Disadvantages and similarities between CTA and DSA, do not vary and do not significantly affect the end decision. This makes CTA a valid tool as the first step in the assessment of the patient with ALI.
文摘Compounds containing nitrogen stored in bark play a significant role in the growth of trees, especially of deciduous trees. Many physiological and biochemical studies have been made in regard to the composition accumulation and mobilization of the nitrogen compounds in bark, but report on the cytological aspect has scarcely been seen. This brief report deals with the protein-storing cells we found in the secondary phloem of Hevea brasiliensis stem.
文摘Cardiogenic shock(CS)is a complex clinical syndrome with a high mortality rate.It can occur to due to multiple etiologies of cardiovascular disease and is phenotypically heterogeneous.Acute myocardial infarction-related CS(AMI-CS)has historically been the most prevalent cause,and thus,research and guidance have focused primarily on this.Recent data suggest that the burden of non-ischemic CS is increasing in the population of patents requiring intensive care admission.There is,however,a paucity of data and guidelines to inform the management of these patients who fall into two broad groups:those with existing heart failure and CS and those with no known history of heart failure who present with"de novo"CS.The use of temporary mechanical circulatory support(MCS)has expanded across all etiologies,despite its high cost,resource intensity,complication rates,and lack of high-quality outcome data.Herein,we discuss the currently available evidence on the role of MCS in the management of patients with de novo CS to include fulminant myocarditis,right ventricular(RV)failure,Takotsubo syndrome,post-partum cardiomyopathy,and CS due to valve lesions and other cardiomyopathies.
文摘The authors regret having a mistake in the article title‘Incidental bilateral ovarian paraganglioma of uterine fibroid with widespread adenomyosis:A case report’and change it to‘Incidental bilateral ovarian paraganglioma in the background of uterine fibroid and widespread adenomyosis:A case report’.The authors would like to apologise for any inconvenience caused.
基金This study was approved by the Institutional Review Board of the State University of Piauí,Teresina(PI),Brazil(CAAE:54885322.2.0000.5209,reference number:5.206.809,approval date:01/20/2022).
文摘Dear editor,Ovarian paragangliomas are rare tumours and are usually incidental.Most of the cases are associated with dermoid cyst of ovary.However,functional paragangliomas1 and paragangliomas leading to peritoneal carcinomatosis are also known in literature.2 Due to the varied behaviour of these tumours,correlation with biochemical markers and long term follow up are advised.In this study,we present a lady in her 60's with recent onset of postmenopausal bleeding.She completed her cervical smears till date and had two children by vaginal delivery.Her past medical history includes hypertension and is on Candesartan for the same.She also has type 2 diabetes and is diet controlled.She is a non-smoker and consumes alcohol very occasionally.
